| NPI | 1942675350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MAE BROOKS Office Coordinator 314-503-1746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2015009900) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |